Early postoperative quality of life in glioma patients - A prospective cohort study

Since gliomas have no cure, the quality of life (QoL) reported by patients assumes utmost importance in the therapeutic strategy. However, few studies have provided longitudinal data about how surgical resection impacts QoL as reported by patients, and even fewer have included preoperative assessments. The aim of this pilot study was to assess how glioma patients' QoL changes in the early postoperative period of glioma resection, at 1 month and 6 months, compared to preoperative.

Patients undergoing surgical resection of low-grade glioma (LGG) or high-grade glioma (HGG) were prospectively included from January 2022 to December 2022. To analyze patient-reported QoL we used EORTC QLQ-C30 and BN20 questionnaires applied preoperatively and at 1 and 6 months after surgery.

We evaluated 34 patients (LGG-9; HGG-25). There were no differences in QoL at all evaluation time points between LGG and HGG groups. Within the LGG patients, QoL scores remained stable throughout 1- and 6-month evaluations. In patients with HGG, when compared to baseline, there were no meaningful variations in QoL at 1 month, but a clinically and statistically significant improvement (p=0.035) was found at 6 months. Total resection was associated with improved QoL in HGG patients at 6 months (p=0.025). At individual level, considering a minimum clinically significant value of 10, most HGG patients improved their QoL, while most LGG patients remained stable. Regarding subdomain analysis, a clinically and statistically significant improvement in future uncertainty was found in both LGG (p=0.042) and HGG (p=0.024) patients at 6 months.

Contrarily to previous studies that revealed a deterioration in HGG patients at 6 months, our preliminary data suggest an improvement in the QoL of these patients at 6 months. Additionally, total resection seems to be beneficial, as it was not associated with QoL deterioration, and can even improve QoL.